The next decade will be a crucial period in the public health response to hepatitis C virus (HCV) infection. The rapid development of direct-acting antiviral (DAA) therapy for HCV infection has brought considerable optimism to the HCV sector, with the realistic hope that therapeutic intervention will soon provide near optimal efficacy with well tolerated short duration all oral regimens. As the zenith in HCV therapeutic development approaches, there remain several key obstacles to the broad implementation of interferon-free DAA regimens. The extent of HCV screening and disease assessment, global and national public health prioritization, and drug pricing will determine the potential impact on disease burden derived from introduction of these exciting new HCV therapies. Public health partnerships and advocacy will be crucial to remove barriers to enhanced HCV treatment access.